The University of Massachusetts Amherst

Improving Diagnosis and Treatment of Substance Use Disorders in Emergency Contexts

Team Pic

From Left: Katherine Dixon-Gordon (psychological & brain sciences); Karen Kalmakis (nursing); Linda Isbell, PhD (psychological & brain sciences); William Soares (emergency medicine, UMass Medical School, Baystate); Elizabeth Schoenfeld (emergency medicine, UMass Medical School, Baystate)

A substantial proportion of emergency department (ED) visits are due to substance misuse. Although providing these patients with a brief screening and treatment referral is efficacious, less than half of ED staff provide such referrals. ED patients with substance misuse constitute a population at the intersection of multiple social and economic sources of health care disparities. The ED is mandated to treat all presenting patients; consequently, the ED disproportionately serves as the first, and often only, treatment for low income, underinsured patients, and substance misuse is more often associated with ED visits among underinsured patients. Further, minority racial groups tend to have less access to needed substance use treatments in general. Several factors may underlie this disparity in the delivery of health care to this disadvantaged group, including negative attitudes towards substance use disorders, lack of training, and insufficient resources. The present study goals are to identify disparities in health care provision to substance users in the ED, and to examine the role of provider attitudes about substance misuse, training, and resources in these disparities. The long-term goal of this research program is to understand and reduce barriers to effective service provision for substance misuse-related difficulties in the ED. These pilot data will support a grant application to the Agency for Healthcare Research and Quality (AHRQ).